A prognostic assay and kit and method of use thereof are provided. The kit and assay are used to determine the likelihood of a diseased cell or tissue having a therapeutic response to treatment with a cardiac glycoside in a disease having an etiology associated with excessive cell proliferation. The kit and assay are used to determine the ratio of isoforms of the α subunit of Na, K-ATPase obtained from the diseased cell or tissue. The kit can be used to predict the therapeutic responsiveness of cancer or tumor in a subject to treatment with a cardiac glycoside. The kit and assay can be incorporated in a method of treating a disease or disorder having an etiology associated with excessive cell proliferation with a composition comprising a cardiac glycoside.
Legal claims defining the scope of protection, as filed with the USPTO.
1. A method of determining whether a subject having a disease or disorder having an etiology associated with excessive cell proliferation should be treated with a cardiac glycoside, the method comprising: providing or assembling a kit comprising at least the following components: a) a first primary antibody having a binding affinity for the α3 subunit isoform of Na, K-ATPase; and b) a second primary antibody having a binding affinity for the α-1 subunit isoform of Na, K-ATPase; obtaining a sample of tissue from the subject, the tissue exhibiting a disease or disorder having an etiology associated with excessive cell proliferation, the sample comprising one or more isoforms of the αsubunit of Na, K-ATPase; with the kit, determining the ratio of α3 isoform to α1 isoform of Na, K-ATPase α-subunit in the sample, wherein the step of determining the ratio comprises: a) quantifying the level of expression of each the α3 subunit isoform of Na, K-ATPase and the α1 subunit isoform of Na, K-ATPase in the sample, and calculating the ratio thereof; or b) determining the amount of the α3 subunit isoform of Na, K-ATPase relative to amount of the α1 subunit isoform of Na, K-ATPase in the sample, and calculating the ratio thereof; wherein according to the ratio of α3 isoform to α1 isoform of Na, K-ATPase, were the subject to be treated with a therapeutically relevant dose of cardiac glycoside, the probability that there will be at least a partial therapeutic response is related to the ratio of α3 isoform to α1 isoform of Na, K-ATPase according to the following table; Probability that there will be a Ratio therapeutic response in the subject 0.3-0.45 +/− 0.05 20-<30% 0.5-0.95 +/− 0.05 30-50% >/=1 +/− 0.05 >50% >10 >75% and if the ratio is ≧0.3, indicating the subject should be treated with cardiac glycoside by administration of a composition comprising cardiac glycoside to the subject, or if the ratio is <0.3, indicating the subject should not be treated with cardiac glycoside for treatment of the disease or disorder having an etiology associated with excessive cell proliferation.
2. A method of determining the probability of a therapeutic response of a disease or disorder having an etiology associated with excessive cell proliferation in a subject having such disease or disorder, wherein the therapeutic response is to treatment of the subject with a cardiac glycoside, the method comprising: obtaining a sample of tissue from the subject, wherein the tissue is suspected of possessing a disease or disorder, and the tissue comprises one or more isoforms of the α subunit of Na, K-ATPase; providing or assembling a kit comprising at least the following components: a) a first primary antibody having a binding affinity for the α3 subunit isoform of Na, K-ATPase; and b) a second primary antibody having a binding affinity for the α-1 subunit isoform of Na, K-ATPase; with the kit, determining the ratio of α3 isoform to α1 isoform of Na, K-ATPase in the sample, wherein the step of determining the ratio comprises: a) quantifying the level of expression of each the α3 subunit isoform of Na, K-ATPase and the α1 subunit isoform of Na, K-ATPase in the in vitro sample or biopsy sample, and calculating the ratio thereof; or b) determining the amount of the α3 subunit isoform of Na, K-ATPase relative to amount of the α1 subunit isoform of Na, K-ATPase in the in vitro sample, and calculating the ratio thereof; and determining the probability of a therapeutic response, according to the ratio of α3 isoform to α1 isoform of Na, K-ATPase, in the subject were the subject to be treated with a therapeutically relevant dose of cardiac glycoside, wherein the probability that there will be at least a partial therapeutic response is related to the ratio of α3 isoform to α1 isoform of Na, K-ATPase according to the following table; and Probability that there will be a Ratio therapeutic response in the subject 0.3-0.45 +/− 0.05 20-<30% 0.5-0.95 +/− 0.05 30-50% >/=1 +/− 0.05 >50% >10 >75% indicating the determined probability of a therapeutic response.
3. The method of claim 1 further comprising: comparing the content of α3 subunit isoform of Na, K-ATPase and of α1 subunit isoform of Na, K-ATPase in the sample relative to the content of α3 subunit isoform of Na, K-ATPase and/or of α1 subunit isoform of Na, K-ATPase in a positive control sample and/or a negative control sample.
4. The method of claim 1 further comprising: comparing the content of α3 subunit isoform of Na, K-ATPase and of α1 subunit isoform of Na, K-ATPase in a tissue sample where expression of only one of α3 and α1 subunit is known to occur as a control.
5. The method of claim 1 further comprising: conducting a statistical analysis on data from which the ratio is determined.
6. The method of claim 1 further comprising: identifying a subject having a disease or disorder having an etiology associated with excessive cell proliferation.
7. The method of claim 1 further comprising: lysing or disrupting cells, tissues or biopsy samples; or fixing tissue sections for histopathologic examination from diseased in vivo cellular tissue to form the sample.
8. The method of claim 1 , wherein the kit further comprises information specifying how to perform analyses for the α1 and α3 isoforms of the α-subunit of Na,K-ATPase.
9. The method of claim 1 , wherein the kit further comprises information detailing how to interpret prognostic data.
10. The method of claim 1 further comprising: performing a Western blot assay and/or immunohistochemical staining assay on the sample to determine the amount and relative expression of α3 subunit isoform of Na, K-ATPase relative to the α1 subunit isoform of Na, K-ATPase in the sample; and calculating the ratio thereof.
11. The method of claim 10 , wherein the kit comprises an immunohistochemical staining kit comprising: a) antigen unmasking solution; b) buffer; c) endogenous-peroxide activity-quenching material; d) first primary antibody, which is anti-Na,K-ATPase α3 subunit isoform antibody, and second primary antibody, which is anti-Na,K-ATPase α1 subunit isoform antibody; e) non-immune mouse IgG 1 antibody; f) universal antibody reagent comprising a mixture of anti-rabbit IgG and anti-mouse IgG reagents; g) primary chemical stain; h) general counter-chemical stain; i) specific cellular organelle stain; or j) a combination of two or more thereof.
12. The method of claim 1 further comprising: conducting a radiometric or densitometric analysis of a gel in order to: a) determine the content of α3 subunit isoform of Na, K-ATPase relative to the content of α1 subunit isoform of Na, K-ATPase in the sample; and/or b) detect the presence of and quantify the content of α3 subunit isoform of Na, K-ATPase and of α1 subunit isoform of Na, K-ATPase in the sample.
13. The method of claim 1 , wherein the kit further comprises alternative means of determining relative Na,K-ATPase α-subunit composition and isoform ratios, wherein the alternative means comprises: antibodies in an enzyme linked immunoabsorbant assay or protein tissue or cell lysate array; Northern blot analyses for measurement of mRNA to different Na,K-ATPase subunit isoforms; or immunohistochemical staining assay.
14. The method of claim 1 , wherein: a) the sample is an in vitro sample or a biopsy sample; b) the sample is cellular tissue, cellular mass, cellular lysate, membrane preparation prepared from the tissue, mass or lysate, or fixed histopathology slide thereof; and/or c) the sample comprises at least the α1 or α3 isoform of the αsubunit of Na, K-ATPase.
15. The method of claim 1 , wherein the subject is a mammal.
16. The method of claim 15 , wherein the disease or disorder having an etiology associated with excessive cell proliferation is selected from the group consisting of: 1) autoimmune diseases such as antigen-induced arthritis and allergic encephalomyelitis; 2) chronic inflammatory proliferative diseases including rheumatoid arthritis, systemic-onset juvenile chronic arthritis, osteoporosis, and psoriasis; 3) proliferative diseases of the breast including fibrocystic disease; 4) proliferative diseases of the prostate including benign prostatic hyperplasia (BPH); 5) proliferative diseases of the eye including proliferative diabetic retinopathy; 6) vascular proliferative diseases including atherosclerosis and coronary stenosis; 7) cancer; 8) tumor; and 9) other proliferative disease that impacts adversely on mammalian quality of life.
17. The method of claim 16 , wherein the cancer or tumor is selected from the group consisting of colorectal cancer, head and neck cancer, adrenal cortical cancer, anal cancer, bile duct cancer, bladder cancer, bone cancer, bone metastasis, sarcomas of bone, brain cancer, breast cancer, cervical cancer, non-Hodgkin's lymphoma, rectal cancer, esophageal cancer, eye cancer, gallbladder cancer, gastrointestinal carcinoid tumor, gestational trophoblastic disease, Hodgkin's disease, Kaposi's sarcoma, kidney cancer, laryngeal and hypopharyngeal cancer, liver cancer, lung cancer (both non small cell and small cell carcinomas), lung carcinoid tumors, malignant mesothelioma, metastatic cancer, multiple myeloma, myelodysplastic syndrome, nasal cavity and paranasal cancer, nasopharyngeal cancer, neruoblastoma, neoplasms of the central nervous system, oral cavity and oropharyngeal cancer, osteosarcoma, ovarian cancer, pancreatic cancer, penile cancer, pituitary cancer, prostate cancer, retinoblastoma, salivary gland cancer, sarcoma, skin cancer, stomach cancer, testicular cancer, thymus cancer, thyroid cancer, cancer of the ureter; uterine sarcoma, vaginal cancer, vulva cancer and Wilm's tumor.
18. The method of claim 1 , wherein: a) the cardiac glycoside is present in pure form whether derived through extraction of a plant or animal source, synthesized or manufactured through chemical modification of an available cardiac glycoside; or b) the cardiac glycoside is present in an extract.
19. The method of claim 18 , wherein the cardiac glycoside extract was prepared by supercritical fluid (SCF) extraction optionally in the presence of a modifier.
20. The method claim 19 , wherein the SCF extract further comprises at least one other pharmacologically active agent aside from the cardiac glycoside.
21. The method of claim 20 , wherein the other active agent contributes to the therapeutic efficacy of the cardiac glycoside when the extract is administered to a subject.
22. The method of claim 1 , wherein the cardiac glycoside is present in a pharmaceutical formulation or composition.
23. The method of claim 18 , wherein the cardiac glycoside is selected from the group consisting of oleandrin, ouabain, bufalin, digitoxin, digoxin, cinobufatalin, cinobufagin, and resibufogenin.
24. The method of claim 18 , wherein the cardiac glycoside has been obtained from an oleander plant mass.
25. The method of claim 24 , wherein the oleander plant mass comprises Nerium species, such as Nerium oleander, or of Thevetia species, such as Thevetia nerifolia.
26. The method of claim 18 , wherein the extract has been obtained from toad skin or secretions derived therefrom.
27. A method of determining whether a subject having a disease or disorder having an etiology associated with excessive cell proliferation should be treated with a cardiac glycoside, the method comprising: providing a sample obtained from the subject, the sample comprising cellular material exhibiting a disease or disorder having an etiology associated with excessive cell proliferation; providing or assembling a kit suitable for determining the ratio of α3 isoform to α1 isoform of Na, K-ATPase α-subunit in the sample; with the kit, conducting an assay to determine the ratio of α3 isoform to α1 isoform of Na, K-ATPase α-subunit in the sample; wherein according to the ratio of α3 isoform to α1 isoform of Na, K-ATPase, were the subject to be treated with a therapeutically relevant dose of cardiac glycoside, the probability that there will be at least a partial therapeutic response is related to the ratio of α3 isoform to α1 isoform of Na, K-ATPase according to the following table; Probability that there will be a Ratio therapeutic response in the subject 0.3-0.45 +/− 0.05 20-<30% 0.5-0.95 +/− 0.05 30-50% >/=1 +/− 0.05 >50% >10 >75% and if the ratio is ≧0.3 , indicating the subject should be treated with cardiac glycoside by administration of a composition comprising cardiac glycoside to the subject, or if the ratio is <0.3 , indicating the subject should not be treated with cardiac glycoside for treatment of the disease or disorder having an etiology associated with excessive cell proliferation.
28. The method of claim 27 wherein the assay is a Western Blot assay, immunohistochemical staining assay, Northern blot assay, enzyme-linked immunoabsorbant assay, protein tissue assay or cell lysate array assay.
29. The method of claim 27 , wherein the ratio is determined by: a) quantifying the level of expression of each the α3 subunit isoform of Na, K-ATPase and the α1 subunit isoform of Na, K-ATPase in the sample, and calculating the ratio thereof; and/or b) determining the amount of the α3 subunit isoform of Na, K-ATPase relative to amount of the α1 subunit isoform of Na, K-ATPase in the sample, and calculating the ratio thereof.
30. The method of claim 27 further comprising: a) comparing the content of α3 subunit isoform of Na, K-ATPase and of α1 subunit isoform of Na, K-ATPase in the sample relative to the content of α3 subunit isoform of Na, K-ATPase and/or of α1 subunit isoform of Na, K-ATPase in a positive control sample and/or a negative control sample; and/or b) comparing the content of α3 subunit isoform of Na, K-ATPase and of α1 subunit isoform of Na, K-ATPase in a tissue sample where expression of only one of α3 and α1 subunit is known to occur as a control.
31. The method of claim 27 further comprising: a) lysing or disrupting cells, tissues or biopsy samples; or b) fixing tissue sections for histopathologic examination from diseased in vivo cellular tissue to form the sample.
32. The method of claim 27 further comprising: conducting a radiometric or densitometric analysis of a gel in order to: a) determine the content of α3 subunit isoform of Na, K-ATPase relative to the content of α1 subunit isoform of Na, K-ATPase in the sample; and/or b) detect the presence of and quantify the content of α3 subunit isoform of Na, K-ATPase and of α1 subunit isoform of Na, K-ATPase in the sample.
33. The method of claim 27 , wherein the kit further comprises information specifying how to conduct the assay.
34. The method of claim 27 , wherein: a) the sample is an in vitro sample or a biopsy sample; b) the sample is cellular tissue, cellular mass, cellular lysate, membrane preparation prepared from the tissue, mass or lysate, or fixed histopathology slide thereof; and/or c) the sample comprises at least the α1 or α3 isoform of the a subunit of Na, K-ATPase.
35. The method of claim 27 , wherein the disease or disorder having an etiology associated with excessive cell proliferation is selected from the group consisting of: 1) autoimmune diseases such as antigen-induced arthritis and allergic encephalomyelitis; 2) chronic inflammatory proliferative diseases including rheumatoid arthritis, systemic-onset juvenile chronic arthritis, osteoporosis, and psoriasis; 3) proliferative diseases of the breast including fibrocystic disease; 4) proliferative diseases of the prostate including benign prostatic hyperplasia (BPH); 5) proliferative diseases of the eye including proliferative diabetic retinopathy; 6) vascular proliferative diseases including atherosclerosis and coronary stenosis; 7) cancer; 8) tumor; and 9) other proliferative disease that impacts adversely on mammalian quality of life.
36. The method of claim 35 , wherein the cancer or tumor is selected from the group consisting of colorectal cancer, head and neck cancer, adrenal cortical cancer, anal cancer, bile duct cancer, bladder cancer, bone cancer, bone metastasis, sarcomas of bone, brain cancer, breast cancer, cervical cancer, non-Hodgkin's lymphoma, rectal cancer, esophageal cancer, eye cancer, gallbladder cancer, gastrointestinal carcinoid tumor, gestational trophoblastic disease, Hodgkin's disease, Kaposi's sarcoma, kidney cancer, laryngeal and hypopharyngeal cancer, liver cancer, lung cancer (both non small cell and small cell carcinomas), lung carcinoid tumors, malignant mesothelioma, metastatic cancer, multiple myeloma, myelodysplastic syndrome, nasal cavity and paranasal cancer, nasopharyngeal cancer, neruoblastoma, neoplasms of the central nervous system, oral cavity and oropharyngeal cancer, osteosarcoma, ovarian cancer, pancreatic cancer, penile cancer, pituitary cancer, prostate cancer, retinoblastoma, salivary gland cancer, sarcoma, skin cancer, stomach cancer, testicular cancer, thymus cancer, thyroid cancer, cancer of the ureter; uterine sarcoma, vaginal cancer, vulva cancer and Wilm's tumor.
37. The method of claim 27 , wherein: a) the cardiac glycoside is present in pure form whether derived through extraction of a plant or animal source, synthesized or manufactured through chemical modification of an available cardiac glycoside; or b) the cardiac glycoside is present in an extract.
38. The method of claim 37 , wherein the cardiac glycoside extract was prepared by supercritical fluid (SCF) extraction optionally in the presence of a modifier.
39. The method claim 38 , wherein the SCF extract further comprises at least one other pharmacologically active agent aside from the cardiac glycoside.
40. The method of claim 37 , wherein the cardiac glycoside is present in a pharmaceutical formulation or composition.
41. The method of claim 27 , wherein the cardiac glycoside is selected from the group consisting of oleandrin, ouabain, bufalin, digitoxin, digoxin, cinobufatalin, cinobufagin, and resibufogenin.
42. The method of claim 27 , wherein the cardiac glycoside has been obtained from an oleander plant mass.
43. The method of claim 42 , wherein the oleander plant mass comprises Nerium species, such as Nerium oleander , or of Thevetia species, such as Thevetia nerifolia.
44. The method of claim 27 , wherein the extract has been obtained from toad skin or secretions derived therefrom.
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April 29, 2015
November 15, 2016
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